Persistent viral shedding of human adenovirus type 7 in children with severe pneumonia

Abstract To understand host–pathogen interactions and develop effective prevention and control strategies for human adenovirus (HAdV), it is essential to explore the characteristics of HAdV shedding. Hospitalized children <14 years who had severe HAdV pneumonia were tested for HAdV DNA by quantitative real‐time PCR in nasopharyngeal aspirate (NPA). A total of 132 children were enrolled, including 102 patients with HAdV type 7 (HAdV‐7) infection and 12 patients with HAdV type 3 (HAdV‐3) infection. A total of 1372 qualified NPA samples were collected. There was a significant negative correlation between the viral load of HAdV and the course of the disease (Spearman r = −0.547, p = .000). HAdV‐7 load decreased at a rate of 0.089 log10 copies/mL per day (95% CI: −0.096 to −0.081; R 2 = 0.332), and the duration of viral shedding was predicted to be 96.9 days ( y = 8.624–0.089 x ). However, HAdV‐3 load decreased more quickly (95% CI: – 0.229 to – 0.143; R 2 = 0.403), and the duration of viral shedding was 51.4 days ( y = 9.558‐0.186 x ). The median viral load of the HAdV‐7 group at weeks 2 and 3, and more than 3 weeks postinfection was higher than that of the HAdV‐3 group. No significant differences in the duration of viral shedding were found in different gender, age (>2 vs. ≤2 years), and with or without underlying diseases groups. Viral shedding in children with severe HAdV pneumonia persisted, among which HAdV‐7 lasted longer than 3 months and the viral load decreased slowly than HAdV‐3.